Basic Information
| Provider Information | |||||||||
| NPI: | 1710994181 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RICCI | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 MEMORIAL DR STE 220 | ||||||||
| Address2: | |||||||||
| City: | ALTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 620026723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6184741723 | ||||||||
| FaxNumber: | 6184742937 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 MEMORIAL DR | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | ALTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 620026723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6184741723 | ||||||||
| FaxNumber: | 6184742937 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2006 | ||||||||
| LastUpdateDate: | 03/12/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 036071994 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.